Hormones: Saliva Testing vs. Blood Testing

Saliva testing offers many advantages over traditional, blood-based hormone testing.

1. Saliva samples are noninvasive.

There are no needles and no pain involved. Just spit in a vial.

2. Saliva samples do not need to be collected in a lab.

They can be done right at home…or at the office…or in the car (not recommended while driving, though).

3. Saliva testing allows for multiple samples to be done.

For example, cortisol levels vary during the day as part of our normal circadian rhythm, or sleep/wake cycle. Cortisol levels are high in the morning when we wake up, a little lower at noon, even lower at late afternoon, and lowest around midnight when we should be getting deep sleep. This rhythm cannot be measured in one sample. You can easily see that a proper assessment of cortisol requires at least four samples. Now imagine having to drive to the lab four times, having to wait four times, and the pain of getting stuck with a needle four times, all the while your stress level rising which will artificially skew your levels of cortisol – which is a stress hormone. It doesn’t make sense to me, either.

Here is another example and one I commonly use for women experiencing fertility problems.

Levels of estrogen and progesterone vary during the monthly cycle. There are specific days/times when we see the peaks and valleys, ebb and flow of these two critical sex hormones. How can we see the peaks and valleys, ebb and flow if we take one sample of blood on only one day out of the month? You are right, we can’t. And, of course, nobody would want to have blood samples taken every day for 28 days, which is the length of the average menstrual cycle. Saliva testing in this case makes the most sense because samples can be taken everyday, and at home, to map out an entire menstrual cycle.

4. This is THE most important one: Saliva testing measures the free-form, or active-form, of the hormone.

Blood testing, on the other hand, measures both the free/active form and the protein-bound or inactive form. For all of you out there who have been told that your hormone levels are “normal” despite being plagued by hormonal symptoms, this is what is going on: the blood test does not differentiate between free/active form and bound/inactive form. Blood testing measures the total amount of both the free/active and bound/inactive.

Now let me explain what this all means…

Let’s take a random number, say 100, and consider this as the “normal” level. Well, if you have 20 free/active plus 80 bound/inactive you have 100, right? So you are told you are “normal”. And if you have 50 free/active and 50 bound/inactive you are also told you are “normal”. And, if you have 80 free/active and 20 bound/inactive you are again told you are “normal”. Does this seem “normal” to you? I will tell you that 20 free/active feels radically different than 50 free/active or even 80 free/active. And now you understand why you can be told that your blood levels are “normal” despite have symptoms of obvious hormonal imbalance.

Because saliva testing measures only the free/active hormones you have a direct measure of exactly what is happening hormonally in your body.

And now you know the whole story.

Here’s what to do next…

Call or email my office and speak with me directly to see if saliva testing is right for you.